[Congressional Record Volume 140, Number 35 (Thursday, March 24, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 24, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
         DEPARTMENT OF VETERANS AFFAIRS MENTAL ILLNESS RESEARCH

  Mr. CONRAD. Mr. President, I ask unanimous consent that the Senate 
proceed to the immediate consideration of Calendar No. 388, S. 1512, 
requiring the VA to establish centers of excellence for mental illness 
research, education and clinical activities; that the committee 
substitute amendment be agreed to, the motion to reconsider laid upon 
the table; that the bill be deemed read a third time, passed, the 
motion to reconsider laid upon the table, and that any statements 
appear at the appropriate place in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  So the committee substitute amendment was agreed to.
  So the bill (S. 1512) was deemed read a third time and passed, as 
follows:

                                S. 1901

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. PURCHASE AND ERADICATION OF SWINE INFECTED WITH 
                   BRUCELLOSIS.

       (a) In General.--Not later than 30 days after the date of 
     enactment of this Act, the Secretary of Agriculture shall 
     issue regulations that authorize the Secretary to purchase 
     and eradicate swine infected with or exposed to brucellosis 
     in accordance with section 11 of the Act of May 29, 1884 (21 
     U.S.C. 114a).
       (b) Implementation.--Section 102 of Public Law 99-198 shall 
     apply to the issuance of regulations under subsection (a).

  (By request of Mr. Conrad, the following statement was ordered to be 
printed in the Record.)
 Mr. ROCKEFELLER. Mr. President, as chairman of the Committee 
on Veterans' Affairs, I am proud to support S. 1512, a bill to improve 
mental illness education, research, and clinical activity at VA. I 
introduced this bill on September 30, 1993, and, after unanimous 
approval by the Committee, reported the bill with minor revisions on 
March 17, 1994.
  This legislation would require VA to establish up to five centers of 
excellence in the area of mental illness at existing VA health care 
facilities. These centers, to be known as Mental Illness Research, 
Education, and Clinical Centers--MIRECCs--would be a vitally important 
and integral link in VA's efforts in the areas of research, education, 
and furnishing clinical care to veterans suffering from mental illness.
  Mr. President, the need to improve services to mentally ill veterans 
has been recognized for a number of years. For example, the 1985 Report 
of the Special Purposes Committee to Evaluate the Mental Health and 
Behavioral Sciences Research Program of the VA, chaired by Dr. Seymour 
Kety--referred to as the ``Kety Committee''--concluded that research on 
mental illness and training for psychiatrists and other mental health 
specialists at VA facilities were totally inadequate. The Kety report 
noted that about 40 percent of VA beds are occupied by veterans who 
suffer from mental disorders, yet less than 10 percent of VA's research 
resources are directed toward mental illness.
  Little has changed since that report. Information provided to the 
Committee at our August 3, 1993, hearing showed that the percentage of 
VA patients suffering from mental illnesses continues to be 40 percent. 
Likewise, the resources directed to VA's research on mental illness 
have not increased an appreciable amount, hovering near 12 percent of 
the overall research budget.
  Mr. President, VA provides mental health services to nearly three-
quarters of a million veterans each year, yet in the decade between the 
time the Kity Committee began its work and now, there has not been a 
significant effort to focus VA's resources on the needs of mentally ill 
veterans. One of the recommendations of the Kety Committee was to 
establish VA centers of excellence to develop first-rate psychiatric 
research programs within VA. Such centers, in the view of the Kety 
Committee, would provide state-of-the-art treatment, increase 
innovative basic and clinical research opportunities, and improve and 
encourage training and treatment of mental illness.
  Based on the recommendations of the Kety Committee, the Committee on 
Veterans' Affairs began efforts more than 6 years ago to encourage 
research of mental illnesses and to establish centers of excellence. 
For example, in 1988, Public Law 100-322 urged VA to establish three 
centers of excellence, or MIRECCs, as proposed by the Kety Committee. 
In March 1992, Senator Cranston, then Chairman of the Committee on 
Veterans' Affairs, noted that the VA had not taken any action to 
implement those recommendations. Unfortunately, I must tell you today 
that the VA still has done little to implement the recommendations of 
the Kety Committee and has made no progress on the establishment of 
centers of excellence.
  Mr. President, I also note that the January 1991 final report of the 
blue ribbon VA Advisory Committee for Health Research Policy 
recommended the establishment of MIRECCs as a means of increasing 
opportunities in psychiatric research and encouraging the formulation 
of new research initiatives in mental health care, as well as 
maintaining the intellectual environment so important to quality health 
care. The report stated that these ``centers could provide a way to 
deal with the emerging priorities in the VA and the Nation at large.''
  In light of VA's failure to act administratively to establish these 
centers of excellence, our Committee has developed legislation to 
accomplish this objective. The proposed MIRECCs legislation is 
patterned after the very successful Geriatric Research, Education, and 
Clinical Center [GRECCs] program. The MIRECCs would be designed first, 
to attract clinicians and research investigators with a clear and 
precise clinical research mission, such as PTSD, schizophrenia, or 
substance abuse; second, to provide training and educational 
opportunities for students and residents in psychiatry, psychology, 
nursing, social work, and other professions that treat individuals with 
mental illness; and third, to develop new models of effective care and 
treatment for veterans with mental illnesses, especially those with 
service-connected conditions.

  The establishment of MIRECCs should encourage research into various 
treatment outcomes for mental illnesses, an aspect of mental illness 
research which, to date, has not been fully pursued, either by VA or 
other researchers. The bill would require the Chief Medical Director to 
share the activities of the MIRECCs throughout the Veterans Health 
Administration, through continuing education programs at regional 
medical education centers.
  Finally, beginning February 1, 1995, the Secretary would be required 
to submit to the House and Senate Committees on Veterans' Affairs 
annual reports on the MIRECCs and on the efforts to disseminate the 
information throughout the VA health care system.
  At our Committee hearing on August 3, 1993, we received broad support 
for this legislation from representatives of the American Psychiatric 
Association, the National Alliance for the Mentally Ill, and the 
veterans service organizations.
  Mr. President, the VA for too long has made inadequate efforts to 
improve research and treatment of mentally ill veterans and to foster 
educational activities for VA mental health professionals. The 
establishment of MIRECCs would be a large step forward in improving 
care for some of our neediest veterans.
  The Senate has passed comparable legislation in each of the last two 
Congresses. I urge my colleagues to support once again these centers of 
mental illness treatment and research and to be a voice for the needs 
of veterans who suffer, in many cases, in silence.

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